“Childhood Trauma Lasts Forever,” a TEDMED Talk with Nadine Burke Harris, MD

by Erica on December 18, 2017

I happened to watch a TEDMED talk by Dr. Nadine Burke Harris, and was fascinated by what I learned about the impact of  childhood trauma and the ways we can prevent and treat the health outcomes caused by it.

Here’s my summary of Dr. Harris’ TEDMED talk:

In the mid-1990’s, researchers from the CDC and Kaiser Permanente discovered that certain exposures in childhood lead to a dramatic increase in risk for 7 out of the 10 leading causes of death in the USA.

High doses of this exposure impacts children’s:

  • brain development
  • immune system
  • hormonal systems
  • and how DNA is read and transcribed

This exposure triples the child’s lifetime risk of heart disease and cancer, and causes a 20 year difference in life expectancy.

Unfortunately, doctors are not trained to provide routine screenings and treatments for this exposure.

What exposure are we talking about?  CHILDHOOD TRAUMA

Childhood trauma includes abuse, neglect, parents with mental illness, and parents with substance abuse problems.

Dr. Harris finished her residency and began working as a pediatrician in San Francisco’s Bayville Hunters Point community, where she met all of her clinic’s goals and achieved “success.” Unfortunately, though, she also discovered that many kids that were sent to her for ADHD, didn’t really have ADHD.  But many had something else in common- childhood trauma.

DR. HARRIS BEGAN RESEARCHING HOW EXPOSURE TO ADVERSITY IMPACTS THE DEVELOPING BRAINS AND BODIES OF CHILDREN.

She reviewed the CDC and Kaiser Permanante’s Adverse Childhood Experiences Study, also known as ACES, where they interviewed 17,500 adults to identify how many participants experienced the following:

  • physical, emotional, and/or sexual abuse
  • physical and/or emotional neglect
  • parental mental illness
  • incarceration
  • substance abuse
  • parental separation and/or divorce
  • domestic violence

For every yes, the participant received one point as their ACE score.

Researchers determined that their ACE scores reliably correlated to health outcomes.

Please know, though, that ACES are incredibly common.

  • 67% of participants had at least 1 point
  • 12.68% of participants had at least 4 points
  • The higher the ACE score, the worst the participant’s health outcome

If participants had 4+ points, their risks of COPD and hepatitis was 2.5 times that of someone with 0 points.  Their risk of depression was 4.5 times.

If participants had 7+ points, their lifetime risk for lung cancer was tripled, and 3.5 times for heart disease.   

Per Dr. Harris, people assumed these increased risks were due to bad behaviors of the program participants.  This is not true.

Science proves that exposure to early adversity affects the development of children’s brains and bodies.

Researchers found that the brain’s nucleus accumbens – the part of the brain involved in pleasure and rewards that is implicated in substance dependence – is impacted by childhood trauma.

They also found that the brain’s prefrontal cortex – the part of the brain involved in impulse control, executive functioning, and learning – is impacted by childhood trauma.

And they found through MRIs that the brain’s amygdala – our fear response center – is also impacted by childhood trauma.

There are neurological reasons why people who are exposed to high doses of adversity at a young age are more likely to engage in high risk behaviors.

BUT, even if they don’t engage in high risk behaviors, they are still more likely to develop heart disease and cancer. 

Why?

Because the hypothalamic pituitary adrenal access – the brain and body’s stress response system that governs our flight or fight response – releases hormones when we are stressed.

And when children experience trauma, they are highly sensitive to a constant stress activation.  It can impact children’s:

  • brain structure and function
  • developing immune system
  • developing hormonal system
  • and how DNA is read and transcribed

Dr. Harris stated that the medical community needs to use science to screen, prevent, and treat those impacted by childhood trauma.

At the Center for Youth Wellness, Dr. Harris and her colleagues began screening for ACES, and used a multidimensional treatment team to reduce the dose of adversity, and to treat the symptoms with best practices, including:

  • home visits
  • care coordination
  • mental health care
  • nutrition
  • holistic interventions
  • medication
  • parental education on ACES and toxic stress
  • tailoring care for diabetics and asthmatics experiencing toxic stress

Dr. Harris attempted to share this model with the medical community, but there was resistance.

Dr. Robert Block, the former President of the American Academy of Pediatrics said “Adverse childhood experiences are the single greatest unaddressed public health threat facing our nation today.”

The scope and the scale of adverse childhood experiences is quite large, and people mistakenly believe it is “other people” who experience it.

The original ACES study was done in a 70% caucasian community with a 70% rate of college education.

Dr. Harris believes we marginalize the issue because it does apply to us, and we don’t want to look at it.

“We need to interrupt the progression from early adversity to disease and early death…This is treatable. This is beatable…We need the courage to look at the problem in the face. This is real. This is all of us.” -Dr. Nadine Burke Harris

 

 

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